No parent wants to medicate their child. I’ve always been against any kind of long-term meds for my son. Despite the many challenges of having a child with severe autism, medicating him was never an option for me. Sadly, things just took an abrupt turn. All the sudden, my son is taking propranolol for anxiety and aggression, but I guess it may help his other autism symptoms too.
Why Did We Start Using Propranolol For Anxiety
My poor guy has been battling anxiety for over a year now, and these often lead to sudden bouts of aggression and rage too. It’s gotten to the point where both his Mom and I have regular battle wounds (bite marks usually) not too mention the many holes kicked in the wall.
Car rides have become incredibly dangerous for mom. At 12 years old, Ethan(my son) has gotten too big and too strong for her to fend off whilst driving. A few times, Mom has even had to pull over at the nearest parking lot, and wait for me to come take Ethan home safely.
Even with all this, medicating him was never ever something I considered at least not long-term. We will be going on vacation in a couple weeks, which means a 15 hour drive to Florida. Of course, I had concerns about that long car ride.
I was thinking it may be a good idea to have something on hand to calm him down in case of emergencies, like lorazepam, xanax or something like that. Something that would be a one time use just to ensure a safe car ride. Somehow, that ended up with us trying propranolol instead.
My son’s doctor felt more comfortable trying the propranolol for anxiety rather than the other meds, which I didn’t mind. I trust his doctor and he trusts us (which is nice). However, I had no idea it was a long term drug.
I Don’t Like This
I figured we could use it for the car ride. Then, my wife told me he needed to take it 3x/day and warned me that we cannot stop taking it without first weaning. That’s when it hit me, we’re now medicating our son. Suddenly, I was overcome by stress, anxiety, and a fair amount of sorrow.
Don’t get me wrong, I understand how we ended up here, and why we may need this medicine right now. I just always thought we would help our son feel better through our other holistic approaches (diet, proper nutrients, supplements, and/or more targeted medication) and figure out the root cause.
I am not at all against all pharmaceutical drugs, but only when it’s going after a specific condition such as an infection or high blood pressure. However, using something like propranolol for anxiety doesn’t feel very targeted.
I will say that this med can be used on an as needed basis. Many parents do spot use propranolol for anxiety in potentially overwhelming situations and stick to natural stress management strategies on a day to day basis.
I guess our doc knew of our struggles of the last few months, which is why we ended up taking this daily instead.
My Big Problem With Propranolol For Anxiety
My biggest concern with this drug is that it does nothing to get to the root of the problem. What is causing the anxiety and aggression to begin with? Propranolol does nothing to address this question, and it feels more like a band aid fix at best.
Nevertheless, he started taking propranolol for anxiety and everything else yesterday, so I guess we’ll stick with it, for a little while.
I will say that if I do not notice a huge difference, we will start to wean fairly quickly (with his doctor’s supervision of course).
In the meantime, I decided I better learn as much as I can about this drug, so that I can know how it works, the risks and side effects to be on the lookout for. In the remainder of this article, I will share what I’ve learned about using propranolol for anxiety and autism.
What I Learned About Using Propranolol For Anxiety, Autism, & Beyond
Disclaimer: Remember, I’m Simply A Dad not a doctor or pharmacist. This is a very serious decision, so make sure you talk with your doctor about all the risks vs benefits.
What Is Propranolol
Propranolol was developed back in the 1960s to control blood pressure & heart rate control, but has been used for various other things like migraines, and preventing heart attacks.
Propranolol is a beta blocker that blocks norepinephrine in the brain. Essentially, it works by suppressing the fight or flight response. This stress response triggers an increase in heart rate, so beta blockers prevent, or block, norepinephrine from reaching the cell receptor and thus, controlling heart rate and blood pressure.
Propranolol For Anxiety
According to Dr David Beversdorf, propranolol has been used for decades to treat situational anxiety.(ie: before a big test, job interview, or public speaking) Perhaps, calming down the physical symptoms of anxiety can also help to calm down the mental or cognitive symptoms as well.
Again, people having been using propranolol for anxiety for a long, long time. I’ve read numerous blogs and watched several YouTube videos with people talking about their experience. Many of them use the term “life saving” when talking about this drug, so there are certainly people out there who have benefited greatly from taking it.
Some of these bloggers and vloggers also said it didn’t really help long term or that they only use it “as needed” now. One vlogger even said he wasn’t sure if it were the drug that calmed him down or just the fact the he took the pill and waited calmly for it to kick in. I guess there’s a certain amount of placebo effect out there too.
On the other hand, no one really mentioned about any series side effects, so that makes me feel a little better about giving it to my son.
Propranolol For Autism
Kids on the spectrum often have trouble with anxiety and are more sensitive to stressful situations. When I say stressful situations, I mean what they perceive as stressful. Something that seems like a minor annoyance to us (without autism), can really trigger the stress response and full on meltdown for kids with ASD.
Remember A Time When You Were Stressed
We all know what it feels like to be running late to work. We’re all strung out and frantically trying to get there faster. You inevitably get stuck behind the slowest driver in the world, and you begin to think nasty thoughts about that person. Perhaps, you’ve even yelled at that person whom you’ve never even met before.
That is our stress response preventing us from thinking rationally, and we’re just reacting. This is how a lot of kids with autism operate: in a constant state of fight or flight where seemingly mundane things cause huge reactions.
I’ve often said that my son goes through periods of time where he seems to be in this constant fight or flight. If only we could figure out how to break him out of that state, I know he would feel so much better.
Of course, there are tons of holistic and/or natural things you can do to try and relax. Unfortunately, over the past several months, we’ve not found anything that consistently kept our son out of that stressful state, which is why we’ve turned to meds I guess.
It does make sense that using something like propranolol for anxiety can help relieve those physical symptoms of stress and pull them out of fight or flight, which should allow some kids with autism to function better cognitively.
Propranolol For Autism: The Research
There have been studies done with the higher functioning autism population using propranolol. You can take a look at the video below for full details, but essentially propranolol led to improved working memory, problem solving, and language.
I’m in various large Facebook communities with like-minded autism parents. I did a search on each of those groups to learn about the experiences other parents have had using propranolol for anxiety and autism.
It appears to be fairly evenly split. About half the parents reported “life changing” improvements, while the others reported no change at all. Parental reports of adverse reactions were quite minimal, which again makes me feel better about giving it to my son.
Precautions
Who Should Not Take Propranolol For Anxiety
Remember, I’m Simply a Dad, but it appears to me that this drug is relatively safe for both adults and kids(provided you’re using it with a doctor’s guidance). However, there are some people that may want to avoid it.
Avoid taking propranolol for anxiety if you:
- Are allergic to it (duh)
- Have asthma
- Slow heart rate
- A history of depression*
- Pregnant or nursing*
Propranolol & Depression
Beta blockers like propranolol can cause depression, so people with a personal or family history may want to avoid taking it. Of course, this is my opinion, but depression is no fun. I would not want to take a drug that could make me fall back into a hole I work so hard to stay out of.
Propranolol For Pregnant or Nursing Moms
Propranolol is listed as a pregnancy grade C drug. This is the description of Class C according to the US Department of Health:
“Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.”
Nursing Moms
If you’re a new or mom to be, you may want to reconsider taking propranolol. This drug does get into the breast milk. Personally, I know I wouldn’t want my wife taking this med (or any med) while she was nursing unless it was absolutely necessary.
Propranolol is only present at low levels in the breast milk, but with a sensitive newborn or infant, I would not be comfortable with any exposure.
According To Drugs.com:
You should not use propranolol if you are allergic to it, or if you have:
- asthma
- very slow heart beats that have caused you to faint
- a serious heart condition
- babies who weigh less than 4.5 pounds should not be given Hemangeol oral liquid.
To make sure propranolol is safe for you, tell your doctor if you have:
- a muscle disorder
bronchitis, emphysema, or other breathing disorders - low blood sugar, or diabetes (propranolol can make it harder for you to tell when you have low blood sugar)
- slow heartbeats, low blood pressure
- congestive heart failure
- depression
- liver or kidney disease
- a thyroid disorder
- pheochromocytoma (tumor of the adrenal gland)
- problems with circulation (such as Raynaud’s syndrome).
It is not known whether propranolol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using propranolol.
Propranolol can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Propranolol Side Effects
As with any drug, propranolol comes with its fair share of side effects. For a complete list of side effects, follow the link at the end of this article.
The common side effects in children that may need urgent attention include:
Call Doctor ASAP if your child has any of these symptoms:
- cough producing mucus
- difficulty with breathing
- tightness in the chest
Common side effects in kids that you want to talk with your doctor about, but may not be as urgent as the list above.
- anxiety (yep-propranolol for anxiety can cause anxiety)
- dry mouth
- hyperventilation
- irritability
- restlessness
- shaking
- sleepiness or unusual drowsiness
- trouble sleeping
- unusual dreams
Side Effects In Adults:
According to medicineplus.gov:
“Propranolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:”
- dizziness or lightheadedness
- tiredness
- diarrhea
- constipation
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:
- difficulty breathing or swallowing
- rash
- blistering or peeling skin
- hives
- itching
- swelling of the face, throat, tongue, or lips
- feeling faint
- weight gain
- irregular heartbeat
Propranolol may cause other side effects. Call your doctor if you have any unusual problems while you are using this medication.
Check the links at the end of this article to learn more about the side effects, precautions
Interactions With Other Drugs
There are over 1000 drugs and supplements that can interact or interfere with propranolol, so make sure to check the list at the end of the article and read the insert that comes with your prescription bottle.
Benadryl and ibuprofen were 2 OTC meds that we were giving our son to combat seasonal allergies and chronic inflammation. We had to stop these once we started propranolol for anxiety and autism.
“Tell your doctor about all medicines you use, and those you start or stop using during your treatment with propranolol, especially:”
- a blood thinner – warfarin, Coumadin, Jantoven
- an antidepressant – amitriptyline, clomipramine, desipramine, imipramine, and others
- drugs to treat high blood pressure or a prostate disorder – doxazosin, prazosin, terazosin
- heart or blood pressure medicine – amiodarone, diltiazem, propafenone, quinidine, verapamil, and others
- NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others
- steroid medicine – prednisone and others
This list is not complete. Other drugs may interact with propranolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. -drugs.com
Should I Take Propranolol For Anxiety, Autism, Aggression…etc.
One Last Thing To Consider:
When weighing your options on whether or not to use propranolol for anxiety, autism, aggression, or whatever your doctor recommended it for, consider the impact of NOT USING it as well.
Like I said in the beginning, car rides were becoming dangerous for Mom, so either my wife never takes the kids out of the house or something was going to need to change.
Also, Ethan was beginning to bang his head on the walls at home, windows in the car, the concrete sidewalk, and he would smack himself in the back of the head quite regularly.
The last straw happened while happily playing at a local park. He threw himself onto a pile of rocks while playing at creek. This happened without warning. He was playing and smiling minutes before.
Suddenly, something triggered him, and he through his head down on the ground. Had Mom not been there to calm him down and make sure his head stayed off the ground, Ethan may have seriously hurt himself.
Chronic Stress
It’s well accepted that chronic stress wreaks havoc on the body. Left uncontrolled chronic stress will lead to disease. This fact is pretty much undisputed.
My son was stressed out all the time. The tiniest things set him off. While I truly believe there is a root cause behind this, we haven’t been able to get out in front of it.
It’s been nearly 2 years like this, so we had to do something different to prevent future damage to his physical and mental health as we continue to work to discover why his body (and mind) is so stressed out.
In Summary
Our decision to start giving my son propranolol was one that personally gave me a lot of stress and anxiety. I feel like the decision was made too quickly.
My wife and I did not gather the necessary background information, and we never sat down and had the discussion on whether or not it was right for our son.
Now that I’ve spent some time researching propranolol for anxiety and autism, I do feel better- a lot better. I still don’t really like it, but logically, I understand it is necessary for the time being.
Honestly, I don’t feel propranolol is necessary because it could actually help him. Rather, it’s needed because of what could potentially happen if we did not start propranolol for anxiety and aggression.
That is the far scarier prospect.
We’ve only been on the medicine for a couple days, but so far so good. He seems to be more like himself with fewer bouts of anger and aggression. Mom even felt comfortable enough to drive him to the store last night. Considering how things have been in the car, that was a big win.
We’ll continue to monitor things to make sure he stays safe. As we get more time and experience with this medicine, I will come back in a month or two to update this post and share our experience for better or for worse.
We started propranolol for his anxiety on June 12, 2019. If you’re interested in seeing what happens, subscribe to ImSimplyaDad.com(enter email below), and I’ll let you know when this post is updated.
References/Future References
- https://chemm.nlm.nih.gov/pregnancycategories.htm
- https://doi.org/10.1177/0269881115612236
- https://www.healthline.com/health/propranolol-oral-tablet
- https://www.statnews.com/2017/10/25/anxiety-performance-propranolol/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4724794/
- https://www.medicalnewstoday.com/articles/316061.php
- https://www.pdr.net/drug-summary/Propranolol-Hydrochloride-Oral-Solution-propranolol-hydrochloride-2656#topPage
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021438s013s014lbl.pdf
- https://www.anxieties.com/159/panic_medication_Betas#.W8EYdi-ZP-Y
- https://www.drugs.com/propranolol.html
- https://ww2.mc.vanderbilt.edu/adc/38888
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137920/
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